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PCRM Responds to New Study on Vegetarian Diets Among Adolescents and Young Adults

WASHINGTON—A study was published in the April 2009 issue of the Journal of the American Dietetic Association on vegetarian diets and eating disorders. The study appears to have been misinterpreted by some reporters as suggesting that a vegetarian diet might lead to eating disorders. This is not what the study showed.

Children and young adults following vegetarian diets have more healthful eating habits than other children and are less likely to develop weight problems. While people with eating disorders sometimes adopt vegetarian diets, no evidence suggests that vegetarians are likely to fall prey to eating disorders.

"When a child decides to become a vegetarian, that is something to be welcomed," said Neal Barnard, M.D., president of the Physicians Committee for Responsible Medicine. "This is not a reason for worry; it is a reason for parents to be happy—that child has just cut his or her risk of being overweight or having heart disease."

Here is a brief summary of the study’s findings.

The study included individuals from 15 to 23 years of age who were asked, “Are you a vegetarian now?” and “Have you ever been a vegetarian?” The term “vegetarian” was apparently loosely interpreted by the participants; 46 percent of those who considered themselves to be vegetarians still ate fish and 25 percent ate chicken.

Of 2,516 participants, 2,112 had never tried a vegetarian diet, 268 had followed a vegetarian diet in the past, but were not currently vegetarian, and 108 were currently vegetarian.

The vegetarians had the most healthful diets, consuming more fruits, more vegetables, and less fat, compared with the nonvegetarians. Body weight among the younger vegetarians (aged 15-18) was similar to that of the nonvegetarians, but vegetarians aged 19-23 were less likely to be overweight or obese, compared with nonvegetarians: obesity was reported in 14.0 percent of the never vegetarians, 10.7 of the former vegetarians, and 5.8 percent of the current vegetarians. Younger vegetarians were also less likely to use alcohol, cigarettes, or drugs, compared with the other groups.

In the younger participants (aged 15-18), the vast majority reported no signs of any eating disorder. However, a history of at least one binge-eating episode was reported in 21.2 percent of vegetarians, compared with 4.4 percent of never vegetarians. Unhealthful weight control behaviors (vomiting, or use of diet pills, laxatives, or diuretics) were reported by 19.6 percent of vegetarians and 9.6 percent of never vegetarians. In the older participants (aged 19-23), binge-eating was reported by 18.4 percent of vegetarians, compared with 5.2 percent of never vegetarians. Unhealthful weight-control behaviors were reported in 15.5 percent of vegetarians and 14.9 percent of never vegetarians. In other words, unhealthful eating behaviors were somewhat more frequent among the vegetarians, although they were by no means common in any of the groups studied.

Nothing in the study suggested that vegetarian diets cause eating disorders. Rather, the reverse is more likely true. That is, some people with eating disorders eventually stop eating meat. The vast majority of study participants reported adopting vegetarian diets because of concerns about animals or the environment, or because of a dislike of the taste of meat. However, people with eating disorders avoid certain foods, and meat is one of the commonly avoided products. Vegetables, fruits, and similar foods tend not to elicit a disgust response, while meat is often described as off-putting. A comparison of the aesthetics of a grocery store’s produce section and its meat department makes this point clearly.

In a prior study by O’Connor, fewer than 10 percent of people with anorexia had any history of avoiding meat before the onset of symptoms. This suggests that, while anorexia may lead to people to shift to a vegetarian diet, vegetarians are not at risk of developing an eating disorder.

The study authors also speculated that some young people with eating disorders may describe themselves to their parents as vegetarians as a means of rationalizing or disguising their food aversions.

Vegetarian diets do not lead to eating disorders and may actually help protect against them. Meat-eaters are more likely than vegetarians to gain weight, and overweight is a powerful stimulus for dietary restriction.

Annual per capita meat consumption rose from approximately 150 pounds in the early 1900s to more than 200 pounds currently. In the same time period, annual per capita cheese intake rose from less than four pounds to more than 32 pounds. These food products have played a major role in the excess caloric intake of adults and children, leading to weight problems and an understandable preoccupation with weight loss. Vegetarians are less likely to need to diet, compared with meat-eaters.

For complete nutrition, vegetarians should include a variety of whole grains, legumes, vegetables, and fruits and take a daily multiple vitamin or other reliable source of vitamin B12.

Founded in 1985, the Physicians Committee for Responsible Medicine is a nonprofit health organization that promotes preventive medicine, conducts clinical research, and encourages higher standards for ethics and effectiveness in research.